AP, via Time.com, informs us that Dewayne Johnson, 46, alleged that heavy contact with the herbicide Roundup caused his non-Hodgkin's lymphoma. On August 10 the California Superior Court jury agreed that Roundup contributed to Johnson's cancer and Monsanto, the manufacturer of the herbicide, should have provided a label warning of the potential health hazard. Monsanto has denied a link between the active ingredient in Roundup - glyphosate - and cancer, saying hundreds of studies have established that glyphosate is safe.

In a matter of less than a decade, "shared decision-making" (SDM) has emerged as the uncontested principle that must inform doctor-patient relationships everywhere. Consistently lauded by ethicists and medical academics alike, it has attracted the attention of the government which is now threatening to penalize doctors and patients who do not participate in SDM prior to providing certain treatments, even if the legal process of informed consent has been fulfilled - and even if the treatment is widely considered to be clinically justified.

For example, in a recent issue of JAMA, an editorial approvingly reports that the Center for Medicare and Medicaid Services will soon refuse to pay physicians and hospitals for the implantation of cardioverter-defibrillators unless the decision to implant these life-saving devices was "shared" with the patient. Although the announcement is short on details regarding the formal process by which SDM must be documented to have occurred, the new policy certainly testifies to the unquestioned status SDM has rapidly acquired as a general principle of medical ethics.

The Trump administration has proposed a rule that would scale back protections currently in place that allow rebates between drug manufacturers and insurers and pharmacy benefits managers, according to the Office of Management and Budget (OMB) website. Details of the proposed rule have not yet been made public, but its title on the OMB site refers to removing the safe harbor protection for rebates from the anti-kickback law.